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Portuguese recommendations for the treatment of psoriasis with biologic therapy

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European Journal of Dermatology

Abstract

Psoriasis is a highly prevalent chronic, inflammatory multisystem disease with a considerable impact on patients’ quality of life and the healthcare system. This report presents the recommendations developed by the Portuguese Psoriasis Group of the Portuguese Society of Dermatology and Venereology that address several clinical questions arising during the management and care of psoriasis with biologic therapy, based on the available evidence. The recommendations were generated following thorough evaluation of existing guidelines on the treatment of psoriasis, publications concerning new biologic treatments that have not yet been considered in existing guidelines, as well as expert-based recommendations. Considerations regarding the severity of psoriasis, indications for initiating biologic therapy, parameters to be considered in treatment choice (in particular, treatment goals), as well as recommendations for using and monitoring therapy and screening programmes are also included.

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References

  1. Greb JE, Goldminz AM, Elder JT, et al. Psoriasis. Nat Rev Dis Prim 2016; 24(2): 16082.

    Article  Google Scholar 

  2. Burgos-Pol R, Martínez-Sesmero JM, Ventura-Cerdá JM, Elías I, Caloto MT, Casado MÁ. Coste de la psoriasis y artritis psoriásica en cinco países de Europa: una revisión sistemática. Actas Dermosifiliogr 2016; 107: 577–90.

    Article  CAS  Google Scholar 

  3. Hawkes JE, Chan TC, Krueger JG. Psoriasis pathogenesis and the development of novel targeted immune therapies. J Allergy Clin Immunol 2017; 140: 645–53.

    Article  CAS  Google Scholar 

  4. Marques Pinto G, Filipe P. Guidelines for high-quality use of biologic therapies in adults with plaque psoriasis. Acta Med Port 2012; 25: 125–41.

    PubMed  Google Scholar 

  5. Smith CH, Yiu ZZ, Bale T, et al. British Association of Dermatologists guidelines for biologic therapy for psoriasis 2020 — a rapid update. Br J Dermatol 2020; 183: 628–37.

    Article  CAS  Google Scholar 

  6. Gisondi P, Altomare G, Ayala F, et al. Italian guidelines on the systemic treatments of moderate-to-severe plaque psoriasis. J Eur Acad Dermatol Venereol 2017; 31: 774–90.

    Article  CAS  Google Scholar 

  7. Amatore F, Villani A-P, Tauber M, Viguier M, Guillot B. French guidelines on the use of systemic treatments for moderate-to-severe psoriasis in adults. J Eur Acad Dermatol Venereol 2019; 33: 464–83.

    Article  CAS  Google Scholar 

  8. Menter A, Strober BE, Kaplan DH, et al. Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with biologics. J Am Acad Dermatol 2019; 80: 1029–72.

    Article  Google Scholar 

  9. Nast A, Spuls PI, van der Kraaij G, et al. European S3-Guideline on the systemic treatment of psoriasis vulgaris — Update Apremilast and Secukinumab — EDF in cooperation with EADV and IPC. J Eur Acad Dermatol Venereol 2017; 31: 1951–63.

    Article  CAS  Google Scholar 

  10. Daudén E, Puig L, Ferrándiz C, Sánchez-Carazo JL, Hernanz-Hermosa JM. Consensus document on the evaluation and treatment of moderate-to-severe psoriasis: Psoriasis Group of the Spanish Academy of Dermatology and Venereology. J Eur Acad Dermatol Venereol 2016; 30: 1–18.

    Article  Google Scholar 

  11. Gossec L, Baraliakos X, Kerschbaumer A, et al. EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2019 update. Ann Rheum Dis 2020; 79: 700–12.

    Article  Google Scholar 

  12. Armstrong AW, Puig L, Joshi A, et al. Comparison of Biologics and Oral Treatments for Plaque Psoriasis. JAMA Dermatol 2020; 156: 258.

    Article  Google Scholar 

  13. Sbidian E, Chaimani A, Afach S, et al. Systemic pharmacological treatments for chronic plaque psoriasis: a network meta-analysis. Cochrane Database Syst Rev 2020; 1: CD011535.

    PubMed  Google Scholar 

  14. Yasmeen N, Sawyer LM, Malottki K, Levin L-Å. Didriksen Apol E, Jemec GB. Targeted therapies for patients with moderate-to-severe psoriasis: a systematic review and network meta-analysis of PASI response at 1 year. J Dermatol Treat 2020: 1–15.

  15. https://www.ema.europa.eu/en/documents/product-information/enbrel-epar-product-information_en.pdf.

  16. https://www.ema.europa.eu/en/documents/product-information/humira-epar-product-information_en.pdf.

  17. https://www.ema.europa.eu/en/documents/product-information/remicade-epar-product-information_en.pdf.

  18. https://www.ema.europa.eu/en/documents/product-information/cimzia-epar-product-information_en.pdf.

  19. https://www.ema.europa.eu/en/documents/product-information/stelara-epar-product-information_en.pdf.

  20. https://www.ema.europa.eu/en/documents/product-information/cosentyx-epar-product-information_en.pdf.

  21. https://www.ema.europa.eu/en/documents/variation-report/taltz-h-c-3943-ii-0009-epar-assessment-report-variation_en.pdf.

  22. https://www.ema.europa.eu/en/documents/product-information/kyntheum-epar-product-information_en.pdf.

  23. https://www.ema.europa.eu/en/documents/product-information/tremfya-epar-product-information_en.pdf.

  24. https://www.ema.europa.eu/en/documents/product-information/ilumetri-epar-product-information_en.pdf.

  25. https://www.ema.europa.eu/en/documents/product-information/skyrizi-epar-product-information_en.pdf.

  26. Torres T, Puig L. Treatment goals for psoriasis: Should PASI 90 become the standard of care? Actas Dermosifiliogr 2015; 106: 155–7.

    Article  CAS  Google Scholar 

  27. Puig L. PASI90 response: the new standard in therapeutic efficacy for psoriasis. J Eur Acad Dermatol Venereol 2015; 29: 645–8.

    Article  CAS  Google Scholar 

  28. Carretero G, Puig L, Carrascosa JM, et al. Redefining the therapeutic objective in psoriatic patients candidates for biological therapy. J Dermatol Treat 2018; 29: 334–46.

    Article  CAS  Google Scholar 

  29. Puig L, Dossenbach M, Berggren L, Ljungberg A, Zachariae A. Absolute and relative Psoriasis Area and Severity Indices (PASI) for comparison of the efficacy of ixekizumab to etanercept and placebo in patients with moderate-to-severe plaque psoriasis: an integrated analysis of UNCOVER-2 and UNCOVER-3 outcomes. Acta Derm Venereol 2019; 99: 971–7.

    Article  CAS  Google Scholar 

  30. Duarte R, Campainha S, Cotter J, et al. Position paper on tuberculosis screening in patients with immune mediated inflammatory diseases candidates for biological therapy. Acta Reumatol Port 2012; 37: 253–9.

    CAS  PubMed  Google Scholar 

  31. Fowler E, Ghamrawi RI, Ghiam N, Liao W, Wu JJ. Risk of tuberculosis reactivation during IL-17 inhibitor therapy for psoriasis: a systematic review. J Eur Acad Dermatol Venereol 2020; 34: 1449–56.

    Article  CAS  Google Scholar 

  32. Puig L, Tsai TF, Bhutani T, et al. Safety in moderate-to-severe plaque psoriasis patients with latent tuberculosis treated with guselkumab and anti-tuberculosis treatments concomitantly: results from pooled Phase 3 VOYAGE 1 & VOYAGE 2 trials. J Eur Acad Dermatol Venereol 2020; 34: 1744–9.

    Article  CAS  Google Scholar 

  33. Huang YW, Tsai TF. A drug safety evaluation of risankizumab for psoriasis. Expert Opin Drug Saf 2020; 19: 395–402.

    Article  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Dermatology, Centro Hospitalar Universitário do Porto, Porto, Portugal

    Tiago Torres & Manuela Selores

  2. Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal

    Tiago Torres & Manuela Selores

  3. Department of Dermatology, Hospital Lusíadas, Lisboa, Portugal

    Rui Tavares Bello & Francisco Menezes Brandão

  4. Department of Dermatology, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal

    Maria João Paiva Lopes & Gabriela Marques Pinto

  5. CEDOC, NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Lisboa, Portugal

    Maria João Paiva Lopes

  6. Hospital da Luz, Lisboa, Portugal

    Ana Ferreira

  7. Psoriasis Unit, Hospital CUF Descobertas, Lisboa, Portugal

    Paulo Ferreira

  8. Department of Dermatology, Centro Hospitalar VN Gaia/Espinho, VN Gaia, Portugal

    Paulo Varela

  9. Escola de Medicina, University of Minho, Braga, Portugal

    Artur Sousa Basto

  10. Private practice, Porto, Portugal

    Marta Pereira

  11. Private practice, Lisboa, Portugal

    Antonio Pinto Soares

  12. Department of Dermatology, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal

    Paulo Filipe

  13. Faculty of Medicine, University of Lisboa, Lisboa, Portugal

    Paulo Filipe

  14. Dermatology Research Unit, iMM João Lobo Antunes, University of Lisboa, Lisboa, Portugal

    Paulo Filipe

Authors
  1. Tiago Torres
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  2. Rui Tavares Bello
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  3. Maria João Paiva Lopes
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  4. Francisco Menezes Brandão
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  5. Ana Ferreira
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  6. Paulo Ferreira
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  7. Paulo Varela
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  8. Artur Sousa Basto
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  9. Marta Pereira
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  10. Manuela Selores
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  11. Gabriela Marques Pinto
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  12. Antonio Pinto Soares
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  13. Paulo Filipe
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Consortia

Portuguese Psoriasis Group of the Portuguese Society of Dermatology and Venereology

Corresponding author

Correspondence to Tiago Torres.

Additional information

Disclosure

Funding sources: none.

Conflicts of interest: the authors declare the following conflicts of interest: Torres T: AbbVie, Almirall, Amgen, Arena Pharmaceuticals, Biocad, Boehringer Ingelheim, Biogen, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, LEO Pharma, MSD, Novartis, Pfizer, Samsung-Bioepis, Sandoz, Sanofi. Tavares Bello R: Abbvie, Bioderma, Galderma, Janssen, Leo Pharma, Eli Lilly, Medinfar, Novartis, Pfizer, UCB. Paiva Lopes MJ: AbbVie, Janssen, LEO, Novartis, Pfizer, Octapharma. Menezes Brandão F: Janssen. Ferreira A: AbbVie, Janssen, Leo, Pfizer, Novartis. Ferreira P: Abbvie; Almirall; Eli Lilly; Janssen; LEO Pharma; Novartis; Pfizer. Varela P: Abbvie, Almirall, Biogen, Galderma, Generis, Janssen, Leo Pharma, Eli Lilly, Medinfar, MSD, Novartis, Pfizer, Sanofi. Sousa Basto A: AbbVie, Almirall, Janssen, Leo Pharma, Novartis, Pfizer. Pereira M: Janssen, LEO Pharma. Selores M: Janssen, Novartis, Pfizer. Marques Pinto G: AbbVie, Almirall, Lilly, Janssen, LEO Pharma, Novartis, Pfizer. Pinto Soares A: none. Filipe P: none.

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Torres, T., Tavares Bello, R., Paiva Lopes, M.J. et al. Portuguese recommendations for the treatment of psoriasis with biologic therapy. Eur J Dermatol 30, 645–654 (2020). https://doi.org/10.1684/ejd.2020.3945

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  • DOI: https://doi.org/10.1684/ejd.2020.3945

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